How Effective is Birth Control? A 13-Method Breakdown

Among the many options you have when it comes to sex — from fancy lube to flavored condoms to crazy positions — choosing the right birth control for you is the most important decision you can make. Safe sex is hot sex, people.

By
Lane Moore

Nov 11, 2015

Among the many options you have when it comes to sex — from fancy lube to flavored condoms to crazy positions — choosing the right birth control for you is the most important decision you can make. Safe sex is hot sex, people. Debby Herbenick, PhD, MPH and co-director of Indiana University's Center for Sexual Health Promotion, walks Cosmopolitan.com through 13 options, with effectiveness percentages courtesy of Planned Parenthood.

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IUDs

What it is: IUD stands for "intrauterine device." The devices are small and made of flexible plastic, and need to be inserted by your health-care provider. They come in either copper (ParaGard) or hormonal (Mirena and Skyla). It remains effective for 12 years.

How it works: The hormonal version is an ovulation-inhibitor, preventing the release of an egg from your ovaries that, when fertilized, gets you pregnant. As for the copper (non-hormonal) version, Herbenick says it's not entirely understood how it works, but the copper essentially immobilizes sperm from traveling up your vagina.

What it is: A progestin-only injection you get every three months. Progestin is a hormone that prevents eggs from leaving your ovaries.

How it works: It inhibits ovulation. Additionally, the shot is intended to thicken the cervical mucus to keep sperm from getting to the eggs as well as render the lining of the uterus less friendly to implantation.

Effectiveness: 91 to 99 percent. The progestin-only pills, however, must be taken at the same time every day in order to be effective. Planned Parenthood notes that certain supplements and medicines, including St. John's Wort, can render the pill less effective. And vomiting and diarrhea can also keep it from working.

STD Protection: None.

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Emergency Contraception

What it is: Basically a high concentrated form of hormones taken after sex to prevent pregnancy. See: Plan B.

How it works: Like the other hormonal birth controls, it works by inhibiting ovulation up to five days after unprotected sex. However, if you happen to have ovulated (most women don't know when exactly they're ovulating) before you get to the emergency pill, it's less likely to work.

Effectiveness: Levonogestrel pills (Plan B One-Step and Next Choice One Dose) are up to 89 percent effective when taken within three days after sex, and Ella is 85 percent effective taken within five days after sex.

STD Protection: None.

PlanB

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The Implant (Implanon and Nexplanon)

What it is: A matchstick-size plastic rod inserted by a clinician in the arm. Herbenick says that while this method is becoming a little more popular lately, some health-care providers are concerned that the rod can drift over time and will therefore be hard to locate when you want it removed. (It lasts up to three years.)

How it works: Inhibits ovulation.

Effectiveness: More than 99 percent effective.

STD Protection: None.

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NuvaRing

What it is: An actual ring that is inserted into the vagina for three weeks a month, replaced by a new ring after a weeklong break. On the downside, Herbenick says, it's a challenge for women who aren't comfortable touching their vaginas.

How it works: It inhibits ovulation by releasing estrogen and progestin in the body, which keeps eggs from leaving the ovaries. The benefit for those who experience nausea from birth control pills is that the hormones go straight to the blood stream without affecting the gastrointestinal system, so you won't get queasy.

Effectiveness: 91 to 99 percent effective.

STD Protection: None.

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Female Condom

What it is: Almost never used in the U.S., it's a pouch inserted in the vagina.

How it works: Like the male condom, the female condom prevents pregnancy by keeping the sperm from reaching the eggs with an actual barrier method. Some believe it has the potential to better prevent the spread of HPV as well.

What it is: A small patch stuck to the skin that releases progestin and estrogen.

How it works: The progestin and estrogen released in the body through the patch inhibit ovulation, keeping eggs from leaving the ovaries. Every week for three weeks, you swap in a new patch. Herbenick notes that there have been some concerns about the amounts of hormones in the patch as well as a slightly higher cardiovascular and blood clotting risk. Additionally, some women experience side effects like irritation and redness.

Effectiveness: 91 to 99 percent effective.

STD Protection: None.

Ortho Evra

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The Pull-Out Method

What it is: The guy pulls out before he ejaculates during sex.

How it works: A trickier method, as it's possible that if he ejaculated earlier in the romp, he could have sperm in the urethra that's released in his pre-ejaculate, which can get you pregnant.

Effectiveness: Doing the "withdrawal method" correctly can see rates of effectiveness similar to that of condoms, but again, it's dicey.

How it works: Women abstain from sex (or use withdrawal or a condom) on fertile days. Many women ovulate at different times of the month, and sometimes more than once a month, so it can be difficult to rely on this method, says Herbenick. There's a huge gap between the perfect and actual use of fertility awareness.

Effectiveness: Stats estimate that 24 out of every 100 couples will get pregnant each year if they don't always use the method correctly.

STD Protection: None.

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Diaphragm

What it is: A shallow silicone cup with a flexible ring that you insert into the vagina to cover the cervix.

How it works: The diaphragm must be used with spermicide cream, gel, or jelly to be as effective as possible. It's intended to keep sperm from joining the egg and the spermicide also helps to kill sperm.

Effectiveness: If used correctly, 6 out of 100 women become pregnant each year. If it's not always used correctly, 12 out of 100 become pregnant each year.

STD Protection: None

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The Sponge

What it is: The sponge is a plastic foam disc that's about 2 inches in diameter and contains spermicide. It's inserted deep into the vagina before intercourse and also has a loop attached to the bottom so you can take it out easily.

How it works: The sponge covers the cervix and blocks sperm from entering the uterus to keep the sperm from joining with the eggs. It also continuously releases a spermicide to keep the sperm from moving.

Effectiveness: For women who always use the sponge as directed, 9 in 100 of them get pregnant each year, with that number being greater (20 out of 100 women) for women who have given birth or have been pregnant, and use the sponge every time as directed.